Our Services

Children's Healthcare System, Inc. (CHCS) has entered into agreements with numerous employers, payers and networks from Arkansas and around the nation. CHCS offers its provider members contracting opportunities with a special focus on pediatrics. CHCS members are able to eliminate many of the worries and much of the paperwork associated with managed care contracting. Among the services offered to members are:

Managed Care Contract Offers
The CHCS managed care portfolio includes approximately 30 contracts. Additional contract discussions are ongoing. CHCS and its staff work with payers to develop favorable contract offers that facilitate access to its network members at fair rates of reimbursement.

Contract Administration and Management
CHCS handles the contract administration and management on behalf of its members. Staff are knowledgeable of contractor policies and procedures, payment methodologies and practices and other requirements. CHCS members are provided timely information about the agreements in which they participate as well as any policy/procedural changes that may impact them.

Troubleshooting for Providers and Their Staffs
CHCS' Provider Relations staff work directly with members on managed care issues and the application of related policies and procedures. This "troubleshooting" service is a valuable time saver for members and their staff. Our Provider Relations staff hosts and coordinates the activities of the Managers' Forum that is offered to Administration and staff from all member practice groups. The Managers' Forum meets annually. Its participants are able to surface issues of interest or concern, network with peers and obtain useful educational offerings in a group setting. In addition, the Managers' Forum enables CHCS to obtain valuable input and advice from its members.

Delegation of Credentialing
Children's Healthcare System, Inc. (CHCS) has been approved as a delegate for credentialing by most of its managed care contractors. Credentialing is performed in accordance with current managed care standards promulgated by the National Committee for Quality Assurance (NCQA) and other such organizations.

CHCS Providers complete a single credentialing application at the time they join the corporation and are recredentialed every two years thereafter. CHCS staff respond to all inquiries and requests of its managed care contractors after the Provider completes his or her initial credentialing. This service eliminates most of the paperwork and time Providers traditionally invest in managed care credentialing activities.

Ongoing Education Regarding Managed Care
CHCS members and their employees may draw on CHCS staffs' managed care expertise through in-office inservices and monthly newsletters. Specific educational offerings are available on request.

Contract Performance Monitoring
CHCS agreements are monitored on an ongoing basis with a comprehensive review completed each year. These reviews are based on data and information solicited from all CHCS members as well as findings from CHCS staff monitoring of contractor compliance with terms.

Assistance with Contract Negotiations
A full assessment of current and potential contracts are examined and approved by using the CHCS Board standards and guidelines. CHCS works to capture new contractual opportunities to improve the cost and quality of healthcare for the members and patients we serve and achieve optimal reimbursement. These contracts are reviewed by CHCS legal counsel to ensure the language is fair and reasonable.

Health Insurance Market knowledge/relationships
CHCS provides its members with up-to-date market related information on a variety of payer related and legal issues. CHCS often meets with local representatives and valuable contacts throughout the state to keep abreast of current healthcare changes or issues. CHCS distributes valuable tools and resources on a regular bases to our PHO members to eliminate the time expended on staff research and development.

Membership with Children's Hospital Association - Discount Programs
CHCS is a standing member of the Child Health Advantage physician purchase program by way of ACH's membership with the Children's Hospital Association. CHCS members have access to a wide variety of discount products and services such as vaccines, medical/surgical supplies, pharmaceuticals and other business services.

Research on claim/payor Issues
CHCS serves as an advocate to assist our members with claim issues that cannot be resolved using the normal avenues and result in delay of reimbursement. the PHO also captures market trends or changes to reimbursement policies to ensure the offices have the most up-to-date payment policies and guidelines.

Quarterly Meetings with Provider Relations Director
The CHCS Provider Relations Director holds quarterly meeting with the member representatives to continue to maintain a trusting relationship with our members and referring physicians throughout our network.